| Perry County Medical Center Inc | |
|
115 E Brooklyn St Linden TN 37096-3515 | |
| (931) 589-2104 | |
| (931) 589-2513 |
| Full Name | Perry County Medical Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 115 E Brooklyn St, Linden, Tennessee |
| Authorized Official Name and Position | Phillip B. Tatum (CEO) |
| Authorized Official Contact | 9315892104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Perry County Medical Center Inc Po Box 916 115 East Brooklyn Street Linden TN 37096-0916 Ph: (931) 589-2104 | Perry County Medical Center Inc 115 E Brooklyn St Linden TN 37096-3515 Ph: (931) 589-2104 |
| NPI Number | 1154322303 |
|---|---|
| Provider Enumeration Date | 08/09/2005 |
| Last Update Date | 02/26/2020 |
| Medicare PECOS PAC ID | 4981706330 |
|---|---|
| Medicare Enrollment ID | O20070303000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154322303 | NPI | - | NPPES |
| 3384590 | Medicaid | TN | |
| 0443869 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Jewyl Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154413243 PECOS PAC ID: 2163424250 Enrollment ID: I20070201000589 |
| Provider Name | Phillip B Tatum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992736334 PECOS PAC ID: 0143322594 Enrollment ID: I20070303000049 |
| Provider Name | Jeffrey G Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922095561 PECOS PAC ID: 9739142209 Enrollment ID: I20100805000562 |
| Provider Name | Mark A Graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881977684 PECOS PAC ID: 4486827342 Enrollment ID: I20111109000623 |
| Provider Name | Kristy R King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841278546 PECOS PAC ID: 5597932046 Enrollment ID: I20120124000518 |
| Provider Name | Sherry L Tidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265707533 PECOS PAC ID: 7012163025 Enrollment ID: I20120807000686 |
| Provider Name | Vivian Denise Stokes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144643461 PECOS PAC ID: 0345472742 Enrollment ID: I20140417002147 |
| Provider Name | Kiara Gildersleeve Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447798558 PECOS PAC ID: 3870853682 Enrollment ID: I20180215001196 |
| Provider Name | Frank C Cartwright |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1184706079 PECOS PAC ID: 1557662459 Enrollment ID: I20180806003415 |
| Provider Name | Stephanie Jean Kennedy-southall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588156483 PECOS PAC ID: 3274886940 Enrollment ID: I20181025002226 |
| Provider Name | Amanda G Deason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831676840 PECOS PAC ID: 3274879309 Enrollment ID: I20190110003188 |
| Provider Name | Hannah P Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932719770 PECOS PAC ID: 8820415912 Enrollment ID: I20200903002497 |
| Provider Name | Tywanda Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194960302 PECOS PAC ID: 8325221674 Enrollment ID: I20211115001038 |
| Provider Name | Hailey Nicole Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578155503 PECOS PAC ID: 6406224559 Enrollment ID: I20221121001105 |
| Provider Name | Akishna Glasper-williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629360706 PECOS PAC ID: 7113203100 Enrollment ID: I20230105000269 |
Averett Medical Group Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 62 Medical Dr, Linden, TN 37096 Phone: 931-589-2222 | |
Perry County Community Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2718 Squirrel Hollow Dr, Linden, TN 37096 Phone: 407-948-9306 | |
Walk-in Medical Clinic Of Linden Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 847 Squirrel Hollow Dr, Linden, TN 37096 Phone: 931-589-2600 Fax: 931-589-2602 | |
The Walk In Medical Clinic Of Linden Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 62 Medical Dr, Linden, TN 37096 Phone: 931-589-2600 Fax: 931-589-2602 |